Basic Remedies Relieve Hairy Tongue and Other Common Tongue Changes

December 19, 2012

ROCHESTER, Minn. — Changes in the color or texture of the tongue — even a tongue that appears hairy — usually aren't serious health concerns.

The December issue of Mayo Clinic Health Letter reviews some common and more unusual changes that can occur to the tongue and the papillae, the tiny raised red dots that cover the tongue. Common conditions include:

Geographic tongue: With this condition, areas of papillae become white and more pronounced. The result is a "map" of red, white and pink patches on the tongue. Usually, there are no other symptoms, though some people may be sensitive to hot or spicy foods. This sensitivity can be improved with a topical steroid gel or soothing mouth rinse.

Hairy tongue: Dead cell skins can accumulate between elongated papillae, usually at the middle and back of the tongue. These cells can resemble tan to black hair. Hairy tongue sometimes causes bad breath or a bad taste. Smokers and people with poor oral hygiene are more likely to experience hairy tongue. It can be treated with daily brushing of the tongue and the use of a tongue scraper.

Fissured tongue: Natural grooves on the tongue may become more pronounced with age or with certain diseases such as psoriasis or Sjogren's syndrome. The grooves aren't a concern unless bacteria become trapped in them, causing inflammation. Gentle brushing of the grooves prevents bacterial buildup.

Less common tongue problems merit a trip to the physician for diagnosis and treatment. Some of these conditions include:

Median rhomboid glossitis: A fungal infection can cause small areas of smooth and shiny tongue tissue, usually in the middle back of the tongue. Burning and itching may occur. Antifungal medications are used to treat this condition.

Smooth tongue (glossitis): The papillae shrink or disappear, causing the tongue to appear smooth and shiny. Tenderness or sensitivity to spicy food may occur. Often, glossitis is caused by a deficiency of iron, folic acid or other vitamins. Treatment involves addressing the nutrition deficiency.

Burning tongue: A burning sensation on the tongue occurs and worsens as the day progresses. Conditions such as Sjogren's syndrome, diabetes, underactive thyroid, oral yeast infection or dry mouth can cause burning tongue. Burning tongue also can be related to medications that cause dry mouth. Treatment focuses on managing the underlying condition.

Tongue cancer: This usually appears as a thickened white or red patch, nodule or sore on the side or underside of the tongue. Tobacco, alcohol use and aging are primary risk factors. Treatment involves surgery, radiation therapy and sometimes chemotherapy.